Xarelto (rivaroxaban) oral tablets

Xarelto is a prescription anticoagulant (blood thinner) that contains rivaroxaban.

It is used to help prevent or treat certain blood clots and to reduce stroke risk in some people with atrial fibrillation.

This page reviews common label-based dosing patterns, key safety considerations, and practical handling details, including Ships from Canada to US access for people without insurance.

Because rivaroxaban affects how blood clots form, it is important to understand when it is used, what side effects to watch for, and which medicines can raise bleeding risk. The sections below also summarize strengths, storage basics, and what to expect during prescription processing through a Canadian dispensing pathway.

What Xarelto Is and How It Works

Rivaroxaban is a direct oral anticoagulant (DOAC), a type of medicine that lowers clotting ability. It works by inhibiting Factor Xa (a clotting protein that helps generate thrombin), which reduces the formation of fibrin clots. In plain language, this therapy makes it harder for harmful clots to develop in veins or the heart, which can reduce the chance of complications such as pulmonary embolism or stroke in selected conditions.

CanadianInsulin.com can confirm prescription details with the prescriber when required.

This medicine helps prevent new clots from forming and existing clots from growing, but it does not “dissolve” a clot that is already present. Unlike warfarin, routine INR blood testing is not used to guide day-to-day dosing, although clinicians may monitor kidney and liver function and review bleeding history over time. Always rely on the official product monograph and the prescriber’s directions for the specific indication.

Who It’s For

This anticoagulant is commonly prescribed for specific, label-approved situations where clot prevention or treatment is needed. Indications vary by country, so the prescription and accompanying directions matter. Condition hubs on this site can provide context for common use cases, including Atrial Fibrillation and Blood Clot DVT PE.

In general terms, rivaroxaban may be used for:

• Stroke prevention in non-valvular atrial fibrillation
• Treatment of deep vein thrombosis or pulmonary embolism
• Prevention of recurrent venous thromboembolism
• Post-surgical clot prevention in selected patients
• Selected cardiovascular risk reduction with aspirin

People with active major bleeding should not take it. It is also not appropriate for every heart valve problem; for example, mechanical heart valves require different anticoagulation approaches. Extra caution is common in severe kidney or liver disease, during pregnancy or breastfeeding, and when there is a history of frequent bleeding. For broader background on related conditions, see Coronary Artery Disease and browse Cardiovascular Medicines for other therapies clinicians may use.

Dosage and Usage

Dosing depends on the reason it is prescribed, kidney function, age, and other clinical factors. Xarelto is taken by mouth, and schedules can be once daily or twice daily depending on the indication and strength. Some regimens are started at a higher intensity for a short period and then transitioned to a maintenance schedule. Tablets should be taken exactly as written on the prescription label.

Why it matters: Skipped doses or early stopping can increase clot risk in some conditions.

Typical label-based patterns (not individualized advice) may include:

• Once-daily dosing for stroke prevention in atrial fibrillation
• Twice-daily dosing during initial DVT/PE treatment phases
• Once-daily dosing for longer-term DVT/PE prevention
• Lower-dose twice-daily dosing with aspirin for CAD/PAD indications

Food, timing, and missed doses

Food requirements can differ by strength and indication. Some tablet strengths are directed to be taken with food to support consistent absorption, while others may be taken with or without meals. Timing matters because anticoagulants work best when taken consistently from day to day. If a dose is missed, the correct response depends on the prescribed regimen (once daily versus twice daily) and the reason for therapy. The safest approach is to follow the written directions and contact the prescriber or pharmacist for clarification rather than doubling doses. Before procedures, clinicians may give temporary-hold instructions based on bleeding risk and kidney function.

Strengths and Forms

This medication is supplied as oral tablets. Commonly available strengths in many markets include 2.5 mg, 10 mg, 15 mg, and 20 mg tablets; availability can vary by country and pharmacy supply chain. In practice, the 15 mg and 20 mg strengths are often used for atrial fibrillation or treatment-phase DVT/PE regimens, while 2.5 mg may be paired with aspirin for specific cardiovascular indications.

Xarelto is dispensed as a fixed-dose tablet rather than a dose-adjusted formulation. Some people search for a 5 mg strength, but 5 mg tablets are not standard in most product lines; the prescription should match the strength actually dispensed on the package. If a generic is prescribed, the label may read rivaroxaban with the same mg strength and dosing schedule.

Storage and Travel Basics

Store tablets at controlled room temperature and keep them in the original container until use, unless the pharmacist provides different packaging. Protect the medicine from excess heat and moisture, and keep it out of reach of children and pets. Do not use tablets past the labeled expiry date, and do not share prescription anticoagulants with others.

Quick tip: Keep a photo of the prescription label for travel documentation.

For travel, carry doses in hand luggage to avoid temperature extremes in checked bags. If crossing time zones, clinicians often advise maintaining a consistent interval between doses; do not redesign a schedule without professional input. When other clinicians (including dentists) ask about medicines, list rivaroxaban and any antiplatelet drugs or anti-inflammatories, since combinations can change bleeding risk.

Side Effects and Safety

All anticoagulants can cause bleeding. Commonly reported issues include easy bruising, nosebleeds, gum bleeding, heavier menstrual bleeding, and stomach upset. More serious bleeding can occur in the gastrointestinal tract or, rarely, inside the skull. Seek urgent medical care for symptoms such as coughing or vomiting blood, black tarry stools, sudden severe headache, fainting, weakness on one side, or bleeding that does not stop.

Licensed Canadian pharmacies dispense medications based on the prescription on file.

Important label warnings include the risk of clotting events if anticoagulation is stopped early without an alternative plan, particularly in atrial fibrillation. Another key warning involves spinal or epidural hematoma (a dangerous bleed near the spine) in people receiving neuraxial anesthesia or spinal puncture, especially when other drugs that affect clotting are also used. Xarelto may not be suitable for people with significant active bleeding or certain severe liver problems. Any unexpected bleeding, falls with head injury, or new neurologic symptoms should be evaluated promptly.

Drug Interactions and Cautions

Many interactions relate to bleeding risk. Combining anticoagulants with antiplatelet agents (such as aspirin or clopidogrel) or with NSAIDs (such as ibuprofen or naproxen) can raise the chance of bleeding. Certain antidepressants (SSRIs/SNRIs) may also contribute to bleeding tendency in some people. For background on antiplatelet therapy, see Clopidogrel 75 mg Guide.

Rivaroxaban levels can be affected by strong inhibitors or inducers of CYP3A4 and P-gp (proteins involved in drug metabolism and transport). Examples include some azole antifungals and HIV medicines (which may increase exposure) and drugs such as rifampin, carbamazepine, phenytoin, or St. John’s wort (which may reduce exposure). Clinicians also consider kidney and liver function, alcohol use, and recent surgery when assessing overall bleeding risk. A complete medication list, including over-the-counter products and supplements, helps reduce preventable interactions.

Compare With Alternatives

Several anticoagulants are used for overlapping indications, but they are not interchangeable without clinician guidance. Other DOACs include apixaban and dabigatran, and warfarin is a long-standing option that requires INR monitoring and has more food and drug interactions. Switching between agents can involve timing considerations to avoid gaps or overlap in anticoagulation, so changes should be directed by the prescriber.

On this site, related prescription options may include Eliquis Overview and Warfarin Tablets. Each has different dosing rules, monitoring needs, and interaction profiles, depending on the indication and patient factors. For an overview of warfarin’s role in clot prevention, see Warfarin Clot Prevention.

Pricing and Access

Out-of-pocket expenses for anticoagulants can vary widely. Key drivers include the prescribed strength, days’ supply, whether a generic is substituted, and how the medicine is covered by private insurance or public plans. Some people compare coverage under Medicare or look at retail pharmacy listings, but the most reliable estimate comes from the specific prescription details and the dispensing pharmacy’s quote.

US delivery from Canada is offered through a prescription referral process that routes dispensing to licensed Canadian pharmacies. The platform supports cash-pay access, including for people without insurance. When available, Current Promotions may apply to eligible orders based on site terms. For more educational resources, browse the Cardiovascular Articles collection.

Authoritative Sources

For prescribing details and boxed warnings, consult the official labeling. A neutral starting point is the FDA’s safety information page: FDA Rivaroxaban Information.

For consumer-friendly counseling points, MedlinePlus provides a summary: MedlinePlus Rivaroxaban Overview. For Canadian product listings and monographs, use Health Canada’s database: Health Canada Drug Product Database.

To submit a prescription request, select prompt, express, cold-chain shipping if it appears as an option.

This content is for informational purposes only and is not a substitute for professional medical advice.